HEDIS LPN

Job Title : Clinical Quality LPN

Location : San Antonio, TX 78257 (ON-SITE)

Work Hours : Monday to Friday, 8 : 00 AM – 5 : 00 PM CST

Position Overview

We are seeking a Licensed Vocational Nurse (LVN) to join our Clinical Quality team, this role focuses on improving patient outcomes by identifying and closing care gaps, supporting quality initiatives, and engaging with members and providers through high-volume outreach.

Key Responsibilities

• Identify patients with care gaps and support closure through education, counseling, and appointment coordination.
• Conduct high-volume outbound calls using an auto dialer to address medication non-compliance and schedule pharmacy appointments.
• Handle inbound member calls and route inquiries appropriately.
• Follow call scripts and verify member demographic information.
• Accurately document call outcomes in member / provider records.
• Collaborate with leadership to implement and monitor quality strategies.
• Support PCPs and clinics with quality data collection and reporting.
• Engage clinic staff to develop strategies for closing quality gaps.
• Maintain up-to-date knowledge of HEDIS / STARs standards and guidelines.
• Perform other related duties as assigned.